The Fulham-based Lillie Road Medical Centre's total list size has grown from 4,970 to 24,652 in the four months since it offered access to the GP at Hand video consultation service to people outside its catchment area. Anyone living in a broad area of London or working in central London may be eligible join the service, which requires them to quit their existing practice and register as an out-of-area patient.

A total of 85% of new registrations since November have been from patients aged between 20 and 39 years old, official data from NHS Digital reveal. Of all new patients signing up since GP at Hand was opened up to out-of-area patients, 94% are aged between 20 and 49.

GP leaders have warned that the predominantly young profile of patients joining the service and rules that restrict access for people with complex needs show the service is 'cherry picking' younger, healthier patients.

The profile of the practice has changed beyond recognition since the GP at Hand service was offered to patients outside its Fulham catchment area - with the equivalent of two and half average-sized GP practice lists joining.

GP leaders at the UK LMCs conference in Liverpool last week voted in favour of motions demanding a stop to 'the undermining of general practice by private companies who cherry pick the patients to whom they offer services'.

Online consultations

They backed calls for online consultation schemes to be forced to 'provide a comprehensive package for all patients, and for funding to support the establishment of online consultation services in all GP practices.

Hertfordshire GP Dr Bethan Rees said online consulting was a 'no-brainer' for general practice. But she warned: 'It should be embedded in general practice, not used as part of cherry picking.' She warned that existing GP practices could be forced to close if they lose patients to out-of-area schemes, and would not be around to help patients when they became ineligible for the out-of-area service due to ill health.

One GP at the conference - Dr Lynette Peterson - who said she had worked for GP at Hand, said it was a 'misconception' that the service was all about cherry picking. 'Yes there are some easy patients, but it also attracts patients with multiple morbidities that current providers find difficult to deal with.'

A spokesman for Babylon Health, which provides the technology behind the GP at Hand service said earlier this year that it has a 95% approval rating from patients. A spokesman said: 'GP at Hand is available to everyone, young or old, in good health or not. It is a digitally-led service and is clearly being welcomed by people comfortable with technology in their lives, with hundreds joining every day.'